Riedel Stefan
The Johns Hopkins University, School of Medicine, Department of Pathology, Division of Microbiology, Baltimore, Maryland, USA.
J Clin Microbiol. 2014 Apr;52(4):1028-33. doi: 10.1128/JCM.03102-13. Epub 2014 Jan 8.
Since the inception of evidence-based scientific concepts in medicine in the 19th century, the utility of postmortem microbiologic examinations has been a topic of controversy. For every study describing a lack of correlation between antemortem clinical and laboratory findings and postmortem culture results, there is equal evidence from other studies that indicates at least some limited utility in select cases. While the contributions of autopsies and postmortem microbiologic examinations in the discovery of novel infectious microorganisms are generally appreciated by the medical and scientific societies, the problems of implementing routine procedures in daily autopsy practice clearly relate to the lack of consensus on their broader utility as well as to a lack of regulatory guidelines. This review provides an overview of the literature-based evidence regarding the utility of postmortem microbiologic examinations together with some practical aspects and guidelines for those confronted with the issue of whether to allow or discourage the use of bacteriologic cultures obtained during autopsies.
自19世纪医学中基于证据的科学概念诞生以来,尸检微生物学检查的效用一直是一个有争议的话题。对于每一项描述生前临床和实验室检查结果与死后培养结果之间缺乏相关性的研究,其他研究也有同样的证据表明,在某些特定情况下至少有一定的有限效用。虽然医学和科学界普遍认识到尸检和尸检微生物学检查在发现新型感染性微生物方面的作用,但在日常尸检实践中实施常规程序的问题显然与对其更广泛效用缺乏共识以及缺乏监管指南有关。本综述概述了基于文献的关于尸检微生物学检查效用的证据,以及一些实际情况和指南,供那些面临是否允许或不鼓励使用尸检期间获得的细菌培养物这一问题的人参考。